Candidate: My undergraduate degrees in Biology, Psychology, and Nursing and the PhD in Nursing have provided the educational foundation to become a biobehavioral nurse scientist. My experiences in bedside and transport nursing in the newborn intensive care unit (NICU) have provided the clinical foundation for research in the neonatal population. My long-term career goal is to reduce the severity of neonatal complications and ultimately improve the health of infants who are born at risk for long-term, debilitating outcomes and build the foundation of health across the lifespan. My long-term research goals are to: 1) participate in the translation of pathophysiologic mechanisms and biological measures from bench science to clinical research and practice for infants at risk for adverse outcomes; and 2) develop an evidenced-based screening program for use during the prenatal period to allow for the implementation of health promotion and disease prevention interventions in pregnant women to improve outcomes their newborn infants. The objectives for this K01 application provide the critical development of knowledge and skills necessary to achieve these long-term research goals: obtain training on oxidative stress mechanisms and measurement techniques from an expert bench scientist in oxidative stress for translation to clinical neonatal research; obtain training on behavioral, stress, and immunological mechanisms and measurements in pregnant women from a senior nurse scientist in prenatal research; obtain training on behavioral, stress, and immunological mechanisms and measurements in neonates from a senior nurse scientist in neonatal research; and strengthen academic and professional skills to be an independent nurse scientist. Environment: The University of Nebraska Medical Center (UNMC) is an academic medical center with a hospital affiliate on campus that encourages collaboration across disciplines for research and education. UNMC has a strong research program in Redox Biology with several expert scientists and resources available. As an expert bench scientist in Redox Biology at UNMC, Dr. Matthew Zimmerman will serve as primary mentor to enhance my knowledge on the physiology and measurement techniques associated with oxidative stress. I will participate in several educational and laboratory opportunities to acquire the necessary skills to conduct translational research with a multidisciplinary team. Dr. Ann Berger will serve as a Co-mentor and on-site senior nurse scientist and key mentor to coordinate and track progress towards my goals and objectives. My dissertation research provided data to examine prenatal influences on neonatal outcomes. Therefore, Dr. Jeanne Ruiz, an expert nurse scientist in prenatal biobehavioral research, will serve as a co-mentor to provide education and application of prenatal research into my research program. Since my primary research interest is in the neonatal population, Dr. Rita Pickler also will serve as a Co-mentor because of her expertise in neonatal research and neurobehavioral development in preterm infants. Both Dr. Pickler and Dr. Ruiz have large databases from NIH-funded research and will facilitate analyses related to my research. Research: The primary goal of this career development award is to investigate potential relationships between allostatic load (a bio-psycho-social model of the effects of chronic stress on body systems) in high-risk pregnant women, their newborn infants, and perinatal outcomes. Allostatic load (AL) is conceptually and operationally defined as physiologic dysregulation of AL parameters of inflammation and oxidative stress from the immune system. AL parameters will be measured in the blood of high-risk pregnant women collected between 18-21 weeks gestational age and prior to delivery, in the cord blood collected at birth, and in the blood collected between 24-48 hours after birth in the newborn infant and include specific free radicals (e.g. superoxide, hydroxyl radical, nitric oxide), antioxidants (e.g., bilirubin, glutathione, superoxide dismutase), and inflammatory cytokines (e.g., IL-6, IL-8, IL-10) from the immune system. Sixty women seen by the high-risk maternal-fetal-medicine practice group and their newborn infants with no known congenital anomalies will be recruited. The aims of the research study are: 1) investigate associations between AL parameters in high-risk pregnant women with AL parameters in the cord blood and in their newborn infants; 2) determine relationships among AL parameters in high-risk pregnant women with prenatal complications; and 3) examine associations among neonatal outcomes and AL parameters in high-risk pregnant women, AL parameters in the cord blood collected at birth, and AL parameters in their newborn infants. Successful completion of this study will provide new insight into biological factors associated with prenatal and neonatal complications. This study will advance our understanding of the role that oxidative stress and inflammatory mechanisms may be playing in driving these complications in prenatal and neonatal populations. The significance of this study is that it will enhance knowledge to improve outcomes for infants at risk for adverse outcomes. The training program will develop the applicant to become an independent nurse scientist with a focus on biobehavioral research in maternal and neonatal populations and to conduct translational research using multidisciplinary teams.